Treatment of patients with neurological deficits associated with cerebral vasospasm by intravascular volume expansion

Four patients, including one preoperative patient, developed neurological deficits associated with angiographically proven cerebral vasospasm and were treated with intravascular volume expansion. Indicator dilution techniques were employed to monitor intravascular volume and cardiac functions during treatment. All four patients improved promptly. None of the patients developed cardiac or pulmonary dysfunction despite marked increase in intravascular volume and despite several risk factors such as cardiac symptoms, electrocardiographic abnormalities, and advanced age. The techniques of monitoring and controlling intravascular volume are described. We believe that this is an important therapeutic adjunct for certain aneurysm patients.